MDC2023

KIDS IN THE KITCHEN IS NO LONGER AVAILABLE

PLEASE FILL OUT ONE FORM FOR EACH CHILD ATTENDING

* Indicates required field

CHILD'S NAME *

First

Last

ADDRESS *

GRADE AS OF JUNE 19, 2023 *

AGE AS OF JUNE 19, 2023 *

NAME OF PARENT REGISTERING THIS CHILD *

EMAIL OF PARENT REGISTERING THIS CHILD *

NAME OF PARENT/GUARDIAN BRINGING CHILD TO MDC *

NAME OF PARENT/GUARDIAN PICKING UP CHILD FROM MDC *

OPTION 1 *

OPTION 2 *

OPTION 3 *

PLEASE LIST ANY SPECIAL OR ACADEMIC NEEDS OR TIPS THAT WOULD HELP US WORK WITH YOUR CHILD *

IN CASE OF EMERGENCY *

PHONE NUMBER *

WE RESERVE THE RIGHT TO ASK YOU TO PICK UP YOUR CHILD IF THEY REFUSE TO PARTICIPATE OR CAUSE UNNECESSARY INTERRUPTIONS

PLEASE LIST ANY ALLERGIES OR MEDICAL CONDITIONS WE NEED TO KNOW (children with food allergies unable to be in Kids in the Kitchen) *

I agree to receiving marketing and promotional materials

Submit